BERNICE CUSTOM Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043019222

License Status

NOT RENEWED

Business

First Name

BERNICE

Last Name

CUSTOM

Business Name

BERNICE CUSTOM

Original Issue Date

06/06/1967

Effective Date

03/04/2003

Expiration Date

01/31/2003

City

CHICAGO

State

Zip

60644

County

COOK

Ever Disciplined

LastModifiedDate

10/15/2005